Relationship between Nutrition Intake and 28-Day Mortality Using Modified NUTRIC Score in Patients with Sepsis

• Published in: Nutrients Vol. 11; no. 8; p. 1906
• Main Authors: Jeong, Dae Hyun, Hong, Sang-Bum, Lim, Chae-Man, Koh, Younsuck, Seo, Jarim, Kim, Younkyoung, Min, Ji-Yeon, Huh, Jin Won
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 15.08.2019; MDPI
• Subjects: Adult; Aged; Body mass; Body mass index; Body size; C-reactive protein; Dietary Proteins - administration & dosage; energy; Energy Intake; Female; Humans; Male; Malnutrition; Malnutrition - diagnosis; Malnutrition - mortality; Malnutrition - physiopathology; Malnutrition - therapy; Middle Aged; modified NUTRIC score; Mortality; Nutrient content; Nutrition; Nutritional Status; Nutritional Support - adverse effects; Nutritional Support - methods; Nutritional Support - mortality; Nutritive Value; Parenteral nutrition; protein; Proteins; Retrospective Studies; Risk Assessment; Risk Factors; Sepsis; Sepsis - diagnosis; Sepsis - mortality; Sepsis - physiopathology; Sepsis - therapy; Skin; Soft tissues; Studies; Time Factors; Treatment Outcome; mortality; modified NUTRIC score; sepsis; protein; energy
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11081906

In critically ill patients, malnutrition is known to increase morbidity and mortality. We investigated the relationship between nutritional support and 28-day mortality using the modified NUTrition RIsk in the Critically ill (NUTRIC) score in patients with sepsis. This retrospective cohort study included patients with sepsis admitted to the medical intensive care unit (ICU) between January 2011 and June 2017. Nutritional support for energy and protein intakes at day 7 of ICU admission were categorized into <20, 20 to <25, and ≥25 kcal/kg and <1.0, 1.0 to <1.2, and ≥1.2 g/kg, respectively. NUTRIC scores ≥4 were considered to indicate high nutritional risk. Among patients with low nutritional risk, higher intakes of energy (≥25 kcal/kg) and protein (≥1.2 g/kg) were not significantly associated with lower 28-day mortality. In patients with high nutritional risk, higher energy intakes of ≥25 kcal/kg were significantly associated with lower 28-day mortality compared to intakes of <20 kcal/kg (adjusted hazard ratio (aHR): 0.569, 95% confidence interval (CI): 0.339-0.962, = 0.035). Higher protein intakes of ≥1.2 g/kg were also significantly associated with lower 28-day mortality compared to intakes of <1.0 g/kg (aHR: 0.502, 95% CI: 0.280-0.900, = 0.021). Appropriate energy (≥25 kcal/kg) and protein (≥1.2 g/kg) intakes during the first week may improve outcomes in patients with sepsis having high nutritional risk.